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Metformin + testosterone is a combination therapy involving the use of metformin, a biguanide antihyperglycemic agent, and testosterone, an androgen hormone. This combination has been studied primarily in men with obesity-related hypogonadism and impaired glucose tolerance. Metformin acts by decreasing hepatic glucose production, reducing intestinal absorption of glucose, and increasing insulin sensitivity through activation of AMP-activated protein kinase (AMPK). Testosterone supplementation addresses low endogenous androgen levels. Clinical studies suggest that while both agents independently improve insulin resistance, their combination may provide additional benefits in lowering total and LDL cholesterol, uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine, fibrinogen levels, and increasing plasma testosterone. However, evidence for additive effects on insulin resistance is mixed[2][6]. The combination has also been associated with potential reductions in prostate and colorectal cancer risk[7].
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